OECD Health Statistics 2017 Definitions, Sources and Methods

Transcription

1 OECD Health Statistics 2017 Definitions, Sources and Methods Total hospital employment Number of persons employed (head counts), and number of full-time equivalent (FTE) persons employed in general and specialty hospitals. Self-employed are included. Inclusion - Service contracts with non-employed health professionals on treatment of hospital patients (head counts). Sources and Methods Australia Source of data: FTE data: 2013 onwards: - Australian Institute of Health and Welfare. Hospital resources: Australian hospital statistics. Canberra: AIHW (also at - Australian Bureau of Statistics. Private hospitals, Australia. ABS Cat. No Canberra; ABS. Prior to 2013: - Australian Institute of Health and Welfare. Australian hospital statistics. Canberra: AIHW (also at - Australian Bureau of Statistics. Private hospitals, Australia. ABS Cat. No Canberra; ABS. Head counts data (up to 1991): - Australian Bureau of Statistics. Characteristics of persons employed in health occupations, Australia. ABS Cat. No Canberra: ABS. Method: FTEs are the sum of data from Hospital resources: Australian hospital statistics (for public hospitals) and Private hospitals, Australia (for private hopsitals). - Staff FTEs are for staff in public and private, acute and psychiatric hospitals. - Staff includes salaried medical officers, nurses, other personnel care staff, diagnostic and allied health professionals, administrative and clerical staff, domestic and other staff. For public hospitals there is some variation in data collection amongst the states and territories. - Data represent full-time equivalents employed in ANZSIC 8611 Hospitals (except psychiatric hospitals) and 8612 Psychiatric hospitals. - Years reported are financial years 1 July to 31 June (e.g is reported as 2006). - The AIHW s National Public Hospitals Establishments Database is based on the Public hospital establishments National Minimum Data Set (scope is establishment-level data for public acute and psychiatric hospitals, and alcohol and drug treatment centres) and the Local hospital network Data Set Specification (scope is local hospital networks and all public hospital services that are managed by a state or territory health authority and are included in the General list of In-scope Public Hospital Services developed under the 2011 National Health Reform Agreement). - The ABS Private Hospitals Establishments Collection contains details about the facilities, activities, staffing and finances of all private hospitals, including both private acute and/or psychiatric hospitals and free-standing day hospital facilities. Notes: - Data for public health resources are sourced from the AIHW s National Public Hospitals Establishments Database; data for private health resources are sources from the ABS Private Health Establishments Collections. The two collections differ in methodology, therefore caution should be used when drawing comparisons.

2 - In FTE data, the difference between total hospital employment and the sum of physicians, other health service providers and other staff employed in hospitals correspond to total nursing FTEs (the breakdown between professional nurses and associate professional nurses is not available). Break in series: For , staff employed in providing public hospital services at the Local Hospital Network level or state health authority level were included for the first time (excludes Queensland, for which the data were not available). Therefore, the staff numbers reported for are not comparable with earlier years. Austria Source of data: Austrian Federal Ministry of Health, Hospital Employment. Reference period: 31 December. - Head counts: Data are available only for physicians, nurses, midwives, assistants, and selected other health service providers employed by hospitals (HP.1). - FTE: Total of FTE employed by hospitals (HP.1). - FTE: Up to 2007, this figure is a combined figure of appr. 90 % FTE (in publicly financed hospitals) and 10 % head counts (in private for-profit hospitals; the latter have to report FTE since the year of 2008). Belgium Source of data: SPF Santé publique - Service comptabilité des hôpitaux. - Data exclude independent doctors working in hospitals. Canada Head Counts Source of data: - Up to 1994: Statistics Canada. Hospital Statistics Preliminary Annual Reports. Catalogue Annual, until 1994/95. - From 2005 onwards: Statistics Canada. Survey of Employment, Payrolls and Hours (SEPH) to CANSIM Table Employment (SEPH), unadjusted for seasonal variation, by type of employee for selected industries classified using the North American Industry Classification System (NAICS), annual (persons). - From 2005 onwards: All employees in category 622 (Hospitals) of the North American Industry Classification System (NAICS). Note: Employees by category are from different data sources and may not add up to total hospital employment obtained from Survey of Employment, Payrolls and Hours (SEPH). Full-Time Equivalents Source of data: Canadian Institute for Health Information, Canadian MIS Database, 1995/ /14. - Includes all provinces and territories in all years, but starting in 2004/05 an estimate was made for Quebec. The estimation method changed in 2006/ / /04: Total employment in reporting hospitals in terms of full-time equivalents (one full-time equivalent = 1950 hours of work per year). No adjustment has been made for non-reporting hospitals. Hospital response rates for 1995/96 = 84%, 1996/97 = 83%, 1997/98 = 83%, 1998/99=84%, 1999/2000=91%, 2000/01=93%, 2001/02=95%, 2002/03=96%, 2003/04 = 98%. The response rate is based on the number of beds in hospitals that reported paid hours as a proportion of beds in all operating hospitals. - Estimates for 2004/05 and 2005/06: For the first time, data submitted by Quebec for 2004/05 also included employment in nursing homes affiliated with hospitals. Employment in Quebec hospitals in 2004/05 and 2005/06, excluding affiliated nursing homes, was estimated based on 2003/04 data. - Estimates for 2006/ /14: Starting in 2006/07, it was assumed that the number of full-time equivalent persons per bed in Quebec was the same as in Ontario, for each type of bed separately (e.g., curative care beds, psychiatric care beds, etc.)

3 Chile Source of data: Ministry of Health. The original source is the National Health Human Resources Information System of the Public Sector (hospitals). Nationwide: all Public Hospitals. - Data include only the public sector hospitals. It is not yet possible to report data on hospital employment in the private sector. The public sector attends almost 80% of the Chilean population. - Primary Health Care which belongs to the public health sector is excluded. - From 2013, there is a systematic checking of the exact grade and profession of the Public Hospital Personnel, by crossing the Ministry of Health Databases with the National Register of Individual Health Providers from the Health Superintendence. Estimation method: FTE is calculated on a weekly base of 44 hours (Chilean norm). Deviation from definition: Despite the OECD definition, the service contracts with non-employed health professionals treating hospital patients are not included in these data. Data are available on these contracts, but should be improved in order to reach a higher level of validity and reliability. This concerns mainly physicians. Czech Republic Source of data: Institute of Health Information and Statistics of the Czech Republic. National Health Information System (Annual report on health personnel). - Providers: Hospitals and specialised therapeutic institutes (excluding balneologic institutes, convalescence homes for children, institutes for long-term patients and hospices). - Measurement units: head counts (employees on payroll and employers), FTE (employees on payroll, employers and contractual workers). - Double counting of health workers working in more than one health establishment (applies only to head counts variable). - In 2014, complete data are not available. Estimate is calculated from available data for 2014 and data from Denmark Source of data: - Head counts: The Danish Health Authority, Labour Register for Health Personnel. - FTE: The joint municipal payroll data office (KRL). Reference period: - Head counts: 31 st December. Data show the number for January first the following year. - FTE: yearly average. - Only public section of health staff is included. - Head counts: Data for Service contracts with non-employed physicians, Service contracts with non-employed professional nurses and midwives and Other staff employed by hospital are not available and thus not included in Total hospital employment. - FTE: Data include Other staff employed by hospital. Note: FTE figures are based on the employee's job description, while head counts figures are based on employee s education. Estonia Source of data: Annual report, National Institute for Health Development, Department of Health Statistics. Reference period: : 31 st of December. - Since 2013: November. For , the head count distribution is made according to their main occupational activity. Break in time series: 2013.

4 - The data collection methodology was changed in Aggregated data collection was replaced with data collection on a personal basis. From 2013, the predominant (main) area of practice is based on an occupation with the highest workload. - Previous long-term care hospitals (HP.1) were classified amongst long-term nursing care facilities HP.2 according to the SHA2011 in Therefore, the total number of hospitals decreased in 2013 as well as the numbers of hospital employment. Finland Source of data: THL Health Personnel Statistics; National Institute for Health and Welfare. The data are based on the Employment Register kept by Statistics Finland. Data on physicians employed in hospital is taken from the same source as all other statistics on physicians (Finnish Medical Association). This causes a minor (2%) discrepancy in the total number. Reference period: Data refer to information for the whole year. Break in time series: 2007, due to a change in the classification of economic activities (excluding physicians, for whom the data are taken from a different source with a break in time series in 2010). France Source of data: Ministère de la Santé et des Sports - Direction de la Recherche, des Études, de l'évaluation et des Statistiques (DREES). Data are from the Statistique Annuelle des Établissements de santé (SAE). - Data refer to metropolitan France and D.O.M. (overseas departments). - Total hospital employment includes salaried personnel (medical and non-medical), interns/residents, faisants fonction d internes (FFI) and diplômés inter-universitaires de spécialité (DIS) as well as self-employed medical personnel. Information on self-employed non-medical personnel is not available. Estimation method: - Until 2008, fixed-term contracts were not counted in the head count nor in the FTE. Only the paid monthly average FTE is known. The FTE of fixed-term contracts are estimated by the paid monthly average FTE. Head counts cannot be estimated. - FTE of self-employed medical personnel is not available, but we know the head count of the self-employed. The FTE are estimated from head counts by applying conventional calculating rules according to the working time of the self-employed. Break in time series: - From 2000 onwards, the faisants fonction d internes (FFI) and diplômés inter-universitaires de spécialité (DIS) are not available by specialty. Therefore, the FFI-DIS data have been estimated based on their ratios in the total number of FFI-DIS over From 2009 onwards, head counts of fixed-term contracts are also included for the non medical staff. Previously only head count of rolling contracts and holders and trainees of the public service were counted. - From 2011 onwards, the number of persons employed in nursing structures or in nurses and midwives schools legally depending on hospitals are not counted. - From 2013, the number of geographical establishments for all sectors (public and private) is counted. The number of hospital persons employed is clearly less impacted by the recast than the number of hospitals. Nonetheless, in this recast, the change of the unit surveyed results in a better quality of data collected in general (less double counting than before), so that the quality of data for the number of persons employed can be marginally improved. Germany Source of data: Federal Statistical Office, Health Labour Accounts 2017; special calculation by the Federal Statistical Office; or - Hospital employment comprises employment in all types of hospitals (HP1.1, 1.2 and 1.3) in all sectors (public, not-for-profit and private). - Included are persons employed in general hospitals, mental health hospitals and prevention and rehabilitation

5 facilities. - Data on total hospital employment exclude non-employed physicians and non-employed professional nurses and midwives with service-contracts on treatment of hospital patients. - From 2000 onwards data from Health Labour Accounts have been completely revised. Therefore comparable data before 2000 is not available. Data are rounded to the nearest thousand. Estimation method: The number of FTE is calculated by adding the full and appropriate proportion of part-time occupied employees. FTE are measured by the number of hours of a standard labour contract. Greece Source of data: Hellenic Statistical Authority (EL.STAT.). Reference Period: 31 st December. Administrative staff is included. Hungary Source of data: Hungarian Central Statistical Office (KSH in Hungarian) Report on personnel of health service per ICHA-HP categories: 1.1(General hospitals); 1.2 (Mental health and substance abuse hospitals); 1.3 (Specialty hospitals). Reference period: 31st December. Includes physicians, nurses, other health personnel, ( e.g. pharmacists), health care assistants and other staff. Estimation method: Method used to calculate the number of full-time equivalents (FTE): FTE employment measured by the number of hours actually or usually worked divided by the average number of hours worked in fulltime jobs. Iceland Source of data: The Ministry of Finance and Economic Affairs. Reference period: December each year. Data exclude service contracts with non-employed health professionals who treat hospital patients (head counts). Data as of 2007 revised in Data refers to persons employed in hospitals referring to health care facilities with 24-hour access to a hospital physician. Ireland Source of data: HR Management Information, Health Service Executive. Reference period: 31st December. - Data refer to publicly funded acute hospitals only. All employees under the aegis of Acute Services are included. - Historical data have been restated to cover re-structured health service configuration. Some years' data may remain unchanged. Israel Source of data: The data are based on the Labour Force Survey which is conducted routinely by the Central Bureau of Statistics and includes persons who had worked for at least one hour during the week before the survey, for pay, profit or other consideration. Estimation method: - The data are subject to variations due to sample errors and wide confidence intervals. - Full-time equivalents (FTE) was measured by the number of hours actually worked by health personnel divided by the average hours worked in full-time jobs in Israel. Break in time series: - From January 2012, the Central Bureau of Statistics has made a transition from a quarterly system of measuring labour force characteristics to a new and improved system that better suits the latest international recommendations

6 on employment and unemployment - Monthly Labour Force Survey. Therefore the 2012 data refer to the entire labour force (including the military service) and not to the civilian labour force, as it was before. - In addition to the transition to a monthly survey, in 2012 a new Standard Industrial Classification of Economic Activities based on ISIC was implemented as well as a new Standard Classification of Occupations based on ISCO- 08. The numbers for 2012 are still reported according to the previous classifications, but the numbers for 2013 are based on the new classifications. Further information: and Note: The statistical data for Israel are supplied by and under the responsibility of the relevant Israeli authorities. The use of such data by the OECD is without prejudice to the status of the Golan Heights, East Jerusalem and Israeli settlements in the West Bank under the terms of international law. Italy Source of data: Since 2003: Ministry of Health - General Directorate of digitalisation, health information system and statistics - Office of Statistics. Reference period: 1 st January. - Data available for head counts only. - Since 2003 data refer to public and private hospitals, including private hospitals not accredited by the National Health Service. Japan Source of data: Ministry of Health, Labour and Welfare, Hospital Report (published annually). - Persons employed (including self-employed) in hospitals that are medical institutions with 20 beds or more. - Data for all health professionals are based on a head count until Data for part-time physicians and part-time dentists have been converted to full time equivalent starting in 1987, and data for other health professionals have been converted to full time equivalent starting in FTE data since 2002 include physicians, dentists, medical service personnel, pharmacists, public health nurses, midwives, nurses, assistant nurses, nursing aid personnel, physiotherapists, occupational therapists, orthoptists, prosthetists, dental hygienists, dental technologists, certified social workers, certified care workers, speech therapists, psychiatric social workers, clinical radiologists, clinical x-ray technologists, clinical laboratory technologists, Japanese traditional massage/massage acupressure therapists, judo therapists, nutritionists, other technicians, medical social workers, administrative staff, and other staff. Korea Source of data: Health Insurance Review & Assessment Service, The State of Medical Institutions, each year. Further information at - Medical institutions equipped with at least 30 beds. - Hospital employees: all employees working in the hospitals (full time positions and contract employees). Break in time series: Hospital administrators are excluded from Latvia Source of data: Centre for Disease Prevention and Control; Statistical Report. Reference period: 31 December. Note: Data for full-time equivalent (FTE) not available. Luxembourg

7 Source of data: - Head Counts: Administrative database on social security registration, survey on physicians working in hospitals (IGSS), provider registration database (National Health Insurance). - Full Time Equivalents: National Health Insurance. Head counts: - The definition of heath employment is linked to the SHA provider classification of HP1. - About half of the hospitals have subcontracting contracts for the cleaning and kitchen auxiliary services. People providing these services are not included. Full Time Equivalents: - Doctors are not included, since almost all doctors have private offices and it is very difficult to make the link with hospitals based on administrative sources. - Approximately half of the hospitals have subcontracting contracts for the cleaning and kitchen auxiliary services. People providing these services are not included. - The staff of the specialised institution 'Centre National de Rééducation Fonctionnelle et de Réadaptation de Hamm' is included in data from In 2003: The opening of a general hospital replaced two old private hospitals in July Data for 2008 are estimated. - In 2008: There was no negotiated staff for some of the hospitals. The rate indicated for total hospital staff has been calculated with the staff negotiated for the previous year (for those hospitals only) and should be considered as provisional. Mexico Data not available. Netherlands Source of data: Statistics Netherlands onwards: Data based on BIG Register (register of (para)medical professions); SSB database (microintegrated database of Statistics Netherlands with data from the municipal register, tax register, social security, and business register) : Annual reports social account : Prismant survey : Survey. Does not include self-employed medical specialists who work in the hospital. Estimation method: - Until 2005: The figures present persons employed (FTEs) in general, university and specialised hospitals, including mental hospitals. The data are based on an annual questionnaire among hospitals. All persons paid by the institution, both persons on the payroll and those who are paid by the institution in another way (temporary employees, employees of employment agencies), are included. This means that administrative staff, technicians, maintenance staff, etc., when paid directly by the institution, are included. On the other hand, medical specialists are not all included as these are often self-employed or organised in partnerships per specialty. - The increase between 1997 and 1998 is due to the inclusion of (out-patient) mental health care institutions that have been merged with mental hospitals into integrated mental hospital institutions. Moreover, the data now comprise annual averages and are no longer data per 31 December. Break in time series: , 2006 and 2012 due to changes in the source : due to obligatory reregistration the number of nurses and midwives (and physiotherapists) is lowered substantially. New Zealand Data not available. Note: The health system in New Zealand is characterised by universal healthcare. The health system is predominantly funded with an estimated 83.2% (2010) in health expenditure coming from public sources. A separate

8 publically funded accident and compensation insurance scheme known as ACC funds accident related care, which accounts for an estimated 8.4% of expenditure. Twenty publically owned District Health Boards (DHBs) are funded to undertake planning for all publically funded health services for their geographic populations and to ensure their delivery. DHB own public hospitals, and they themselves deliver a wide range of services. Only data related to DHB employed personnel are available in the New Zealand. (Data have been provided for DHB employed personnel by category of personnel). Norway Source of data: Statistics Norway; Register-based statistics on employment of health-care personnel. Reference period: 3 rd week of November. Deviation from the definition: Data refer to economically active professionals. - The figures provided give the number of practising personnel within HP1. There is no guarantee that these professionals actually work in patient care as data refer to education the individuals have rather than the job they hold within the HP structure. - The health sector in Norway underwent a large reorganisation in Figures are therefore provided from Break in time series: 2009, : New calculation method. - As from 2015, the register-based employment statistics will be based on a new data source for employees. Until the end of 2014, the main data source was The Central Register on Employers and Employees (EE register), produced by the Norwegian Labour and Welfare Organisation (NAV). In 2015, this reporting to NAV was coordinated with the reporting of earnings and personnel data to the Tax Administration and Statistics Norway. This common reporting system is called a-ordningen (the a-system). Poland Data not available. Portugal Source of data: National Statistical Office - Survey on Hospitals. - The Hospital Survey began in This survey covers the whole range of hospitals acting in Portugal: hospitals managed by the National Health Service (public hospitals with universal access), non-public state hospitals (military and prison) and private hospitals. - Information on full time equivalents is not available. Break in time series: - In 1999, a methodological change occurred in this survey. Information regarding qualified nurses and midwives, associate professional nurses and caring staff became available from then on. Therefore, there is a break in the series Other health professionals employed by hospital in The category health care assistants employed in hospital includes nurse s assistants and medical care assistants. Slovak Republic Source of data: National Health Information Center. - Annual report S (MZ SR) 1 01 on network of health care providers for data up to Report on network of health care providers since Data are available for FTE hospital employment in Hospitals - HP1 (according to the recommendations and definitions following the SHA version 1.0.) in the territory of the Slovak Republic (i.e. general hospitals, specialty hospitals, sanatoriums - i.e. hospitals providing long-term care for the chronically ill and hospitals providing rehabilitation and related services to physically challenged or disabled people).

9 - There are no data available for head count. - Total hospital employment includes only health care workers. No data exist regarding other staff. Break in time series: : Data source changed from Annual report S (MZ SR) 1 01 on network of health care providers for years 2008 and earlier to Report on network of health care providers in From 2009 onwards, service contracts with non-employed health professionals are included in the data (which is not the case for data before 2009). Slovenia Source of data: National Institute of Public Health, Slovenia, National Health Care Providers Database. With this database, data on hours worked (FTE) and jobs (number of contracts) were not available. Spain Source of data: - Up to 2009: Ministry of Health, Social Services and Equity from Statistics on Health Establishments Providing Inpatient Care (ESCRI). - Since 2010: Ministry of Health, Social Services and Equity from Specialised Care Information System (Sistema de Información de Atención Especializada - SIAE). - All public and private hospitals in Spain are included. - Number of physicians employed by hospital: doctors in training (interns and resident) are included. - Other health professionals: includes another health staff (university degree or adequate diploma) working in the hospital (e.g. physiotherapists, psychologists, pharmacists, etc.). - Other staff: includes non-health staff working in hospital (e.g. administrative staff, etc.). - FTE data are not available. Break in time series: Until 2009 Family practitioners in training in hospital are included. Since 2010 Family practitioners in training in hospital are excluded. Sweden Data not available. Switzerland Source of data: FSO Federal Statistical Office, Neuchâtel; hospitals statistics; yearly census. Deviation from definition: Self-employed persons (mostly physicians) are not included. Estimation method: Until 2009, the hospital employment estimate was made with data on professions from 75% of hospitals. Break in time series: Hospital statistics have been revised (data year 2010); all categories can be identified; FTE based on yearly average. Note: The method used for FTE calculation is based on detailed data on contractual working hours. Turkey Source of data: General Directorate for Health Services, Ministry of Health. - Physicians, nurses and midwives, other health service providers, and other employees employed by hospitals are included in total hospital employment. - Total hospital employment is available from 2011 onwards because the numbers of other staff employed in hospital are missing before then. United Kingdom

10 Source of data: Office for National Statistics onwards: ONS Labour Force Survey (LFS). Reference period: LFS data are for April to June of each year to fulfill Eurostat s requirement that all countries in the European Union have a Labour Force Survey based on all calendar quarters. Number of people employed (headcount) in the UK in both public and private sectors in either a main or second job in UK SIC (92) sub-class 'hospital activities' (equivalent to ISIC Rev.3 class 8511). Estimation method ( ): - Data may be an underestimate of true figures due to problems with the current coding methodology; however, these are the only figures currently available. - Previous time series has been deleted due to inaccuracies discovered when the coding methodology was recently changed. The previous time series included staff working in residential care facilities in the figures and was consequently inaccurate. Estimation method: 2014 onwards: the Office of National Statistics (ONS) re-weighted the LFS data using revised UK level population estimates consistent with the 2011 census and population projections. United States Source of data: American Hospital Association Annual Survey of Hospitals/Hospital Statistics, 1976, 1981, Editions. Chicago. (Copyrights 1976, 1981, : Used with permission of Health Forum LLC, an affiliate of the American Hospital Association). National. Deviation from the definition: Data match OECD definition. Calculation methods match OECD definition. - The Hospital Statistics draws its data from the AHA Annual Survey of Hospitals. - Data are for all AHA-registered hospitals in the United States. The AHA Survey was mailed to all hospitals, both AHA-registered and non-registered, in the U.S. and its associated areas: American Samoa, Guam, the Marshall Islands, Puerto Rico and the Virgin Islands. - Estimates excluded U.S. associated territories, Puerto Rico and non-registered hospitals. - The U.S. estimates include physicians and dentists, registered nurses, licensed practical nurses and other salaried personnel. - U.S. personnel data included full-time personnel and full-time equivalents for part-time personnel from 1954 onwards. - Overall AHA Survey average response rate: 82%. - U.S. government hospitals located outside the mainland U.S. were not included. - Personnel data include full-time personnel and equivalent of part-time personnel. - Full-time equivalent (FTE) is calculated as full time personnel plus.50 part time personnel. - Head count is calculated as full time personnel plus part time personnel. Estimation: Survey. Break in time series: No breaks in time series. NON-OECD ECONOMIES Lithuania Source of data: Health Information Centre of Institute of Hygiene, data of entire annual survey of health establishments. Reference period: 31 st December - Data for all hospitals excluding nursing hospitals. Service contracts with non-employed health professionals are excluded. - The Annual survey collection includes data on physical persons and full time equivalents. For physical persons: a person is included only if this institution is the main job for this person. If a person is working in several institutions he/she will be presented as a physical person only once. But FTE will be presented for the person in every institution he works.

11 - For full time equivalents data on contractual working hours is presented in annual survey: an employee with a fulltime employment contract is counted as 1 FTE; depending on the contractual hours an employee could work 0.25, 0.5, 0.75, 1.25, 1.5 FTE. OECD, OECD Health Statistics November